Difference between intestinal and extraintestinal amoebiasis
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When Entamoeba histolytica spreads outside a patient's gut, it usually involves his liver. Here it can cause an ''abscess' filled with liquid necrotic liver. To start with this is yellow or yellow-green, later it becomes a syrupy dark reddish-yellow (''anchovy sauce'). The central area of necrosis is surrounded by zones of progressively less damaged tissue and amoebae. The term amoebic liver ''abscess' is a bad one, because there is no pus.
His main symptom is gradually increasing pain in his right hypochondrium, or epigastrium. There is an 80% chance that his abscess is in the right lobe of his liver, where you will be able to detect it clinically, unless it is very deep.
Provided that there are no complications, metronidazole usually treats an uncomplicated liver ''abscess' very effectively, but if it does not, you will have to aspirate it or, rarely, to drain it. The major risk is that it will suddenly rupture into his peritoneal cavity, or through his diaphragm into his lung or pericardium. Rupture into the peritoneal cavity is a dramatic catastrophe, with collapse and peritonitis, like the perforation of a peptic ulcer. Although the contents of an abscess are sterile, they cause an acute inflammatory reaction in the peritoneum. Sometimes, an ''abscess' leaks into the peritoneum slowly, which makes the diagnosis more difficult.
His main symptom is gradually increasing pain in his right hypochondrium, or epigastrium. There is an 80% chance that his abscess is in the right lobe of his liver, where you will be able to detect it clinically, unless it is very deep.
Provided that there are no complications, metronidazole usually treats an uncomplicated liver ''abscess' very effectively, but if it does not, you will have to aspirate it or, rarely, to drain it. The major risk is that it will suddenly rupture into his peritoneal cavity, or through his diaphragm into his lung or pericardium. Rupture into the peritoneal cavity is a dramatic catastrophe, with collapse and peritonitis, like the perforation of a peptic ulcer. Although the contents of an abscess are sterile, they cause an acute inflammatory reaction in the peritoneum. Sometimes, an ''abscess' leaks into the peritoneum slowly, which makes the diagnosis more difficult.
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